Probiotics - A quick in depth tour

An estimated 100 Trillion bacteria forming our Microbiome!

This is in contrast to approximately 10 Trillion body cells that make us human; outnumbering our own cells by a factor of 10:1!.

Although a great deal of research has been done onprobiotics, much remains to be learned.

Some probiotics may help to prevent diarrhea that’s caused by infections or antibiotics. They may also help with symptoms of irritable bowel syndrome. However, benefits have not been conclusively demonstrated, and not all probiotics have the same effects.

In healthy people, probiotics usually have only minor side effects, if any. However, in people with underlying health problems (for example, weakened immune systems), serious complications such as infections have occasionally been reported.

What are Probiotics?

Probiotics are live microorganisms that are intended to have health benefits. Products sold as probiotics include foods (such as yogurt), dietary supplements, and products that aren’t used orally, such as skin creams.

Although people often think of bacteria and other microorganisms as harmful “germs,” many microorganisms help our bodies function properly. For example, bacteria that are normally present in our intestines help digest food, destroy disease-causing microorganisms, and produce vitamins. Large numbers of microorganisms live on and in our bodies. In fact, microorganisms in the human body outnumber human cells by 10 to 1. Many of the microorganisms in probiotic products are the same as or similar to microorganisms that naturally live in our bodies.

History

The concept behind probiotics was introduced in the early 20th century, when Nobel laureate Elie Metchnikoff, known as the “father of probiotics,” proposed that consuming beneficial microorganisms could improve people’s health. Researchers continued to investigate this idea, and the term “probiotics”-meaning “for life”-eventually came into use.

Probiotics may contain a variety of microorganisms. The most common are bacteria that belong to groups called Lactobacillus and Bifidobacterium. Each of these two broad groups includes many types of bacteria. Other bacteria may also be used as probiotics, and so may yeasts such as Saccharomyces boulardii.

Prebiotics are not the same as probiotics. The term “prebiotics” refers to dietary substances that favor the growth of beneficial bacteria over harmful ones. The term “synbiotics” refers to products that combine probiotics and prebiotics.

Science and Evidence

There’s preliminary evidence that some probiotics are helpful in preventing diarrhea caused by infections and antibiotics and in improving symptoms of irritable bowel syndrome, but more needs to be learned. We still don’t know which probiotics are helpful and which are not. We also don’t know how much of the probiotic people would have to take or who would most likely benefit from taking probiotics. Even for the conditions that have been studied the most, researchers are still working toward finding the answers to these questions.

Probiotics are not all alike. For example, if a specific kind of Lactobacillus helps prevent an illness, that doesn’t necessarily mean that another kind of Lactobacillus would have the same effect or that any of the Bifidobacterium probiotics would do the same thing.

Although some probiotics have shown promise in research studies, strong scientific evidence to support specific uses of probiotics for most health conditions is lacking. The U.S. Food and Drug Administration (FDA) has not approved any probiotics for preventing or treating any health problem. Some experts have cautioned that the rapid growth in marketing and use of probiotics may have outpaced scientific research for many of their proposed uses and benefits.

Government Regulation

Many probiotics are sold as dietary supplements, which do not require FDA approval before they are marketed. Dietary supplement labels may make claims about how the product affects the structure or function of the body without FDA approval, but they cannot make health claims (claims that the product reduces the risk of a disease) without the FDA’s consent. (For more information about dietary supplements, see the National Center for Complementary and Integrative Health’s fact sheet Using Dietary Supplements Wisely.)

If a probiotic is marketed as a drug for specific treatment of a disease or disorder in the future, it will be required to meet more stringent requirements. It must be proven safe and effective for its intended use through clinical trials and be approved by the FDA before it can be sold.

Even for healthy people, there are uncertainties about the safety of probiotics. Because many research studies on probiotics haven’t looked closely at safety, there isn’t enough information right now to answer some safety questions. Most of our knowledge about safety comes from studies of Lactobacillus and Bifidobacterium; less is known about other probiotics. Information on the long-term safety of probiotics is limited, and safety may differ from one type of probiotic to another.

For example, even though a National Center for Complementary and Integrative Health (NCCIH)-funded study showed that a particular kind of Lactobacillus appears safe in healthy adults age 65 and older, this does not mean that all probiotics would necessarily be safe for people in this age group.

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